Diabetes Ketoacidosis

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Author:
anhpham
ID:
277573
Filename:
Diabetes Ketoacidosis
Updated:
2014-06-26 14:32:00
Tags:
Diabetes Ketoacidosis
Folders:
Pharmacy
Description:
DKA and treatment
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  1. What are the tree components that should be present so that a patient can be diagnosed w/ DKA?
    • Glucose>250
    • Presence of ketones (in serum or urine)
    • Presence of acidoisis (serum bicarbonate<18 mEq/L and or arterial pH <7.3)
  2. What do we look at to classify the severity of DKA?
    • Serum Bicarbonate (meq/L)
    • Arterial pH
    • Anion gap
    • Mental Status
  3. Criteria to diagnose mild DKA
    • Serum Bicarbonate (meq/L):15-18
    • Arterial pH: 7.25-7.30
    • Anion gap: >10
    • Mental Status: Alert
  4. Criteria to diagnose moderate DKA
    • Serum Bicarbonate (meq/L):10-15
    • Arterial pH:7.0-7.24
    • Anion gap:>12
    • Mental Status:Alert/drowsy
  5. Criteria to diagnose severe DKA
    • Serum Bicarbonate (meq/L):<10
    • Arterial¬†pH: <7.0
    • Anion gap:>12
    • Mental Status: Stupor/coma
  6. What are the three elements of DKA?
    • Marked hyperglycemia
    • Ketosis
    • Acidosis
  7. What process will increase in the absent or insufficient insulin?
    • Glycogenolysis
    • Gluconeogenesis
    • Ketogenesis
  8. Clinical Presentation of DKA
    • Physical signs: dehydration, dry mucus membranes, decreased skin turgor, tachycardia, Kussmaul respirations (rapid adn deep breathing) with acetone smell, hypotension, alteration in mental status, shock, and coma.¬†
    • The history generally: polyuria, polydipsia, polyphagia, weight loss, vomiting, abdominal pain, weakness, and drowsiness.
  9. Anion gap is calculated as
    Sodium - (Chloride + Bicarbonate)
  10. The initial management of DKA
    • 1. Fluid and electrolyte therapy
    • 2. Insulin therapy
    • 3. Treatment of precipitating causes
    • 4. Monitoring of therapy and complications
  11. Precipitating factors of DKA
    • Infection
    • New onset type 1 diabetes
    • Inadequate insulin
    • Poor compliance
    • Myocardial infarction
    • Cerabral vascular accident
    • Acute pancreatitis
    • Drugs
  12. Signs and symptoms of DKA
    • Signs of poorly controlled diabetes
    • Symptoms of the precipitating factor
    • Dehydration
    • Tachycardia
    • Kussmaul respirations
    • Acetone smell on breath
    • Abdominal pain
  13. Total body water deficit formulation
    0.6 x kg x [1- (140/Na)]

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